Foreword[edit | edit source]
What I did[edit | edit source]
I published http://Resiliencemaps.org/files/fluscim in Spanish in 2010, and then translated into English.
Since the beginning of the COVID-19 pandemic, like many others, I've tried to see what else I could do. Worked with http://twitter.com/libresdecovid and started off ZeroCovid and Aerosol pandemic which are patchy and could use work.
In this page I attempt to see what is it I could do next. I do that by looking at what has changed in 10+ years that's relevant to FluSCIM, what stays firmly in place, and what needs a bit more work.
Orientation[edit | edit source]
In general, flu pandemics are thought of as "when, not if". For those who remember 2009, some flu pandemics are basically manageable with current resources and plans.
This page's main focus is "severe enough" pandemics, i.e. those where the virus kills, or quickly disables, a percentage of the working population that is high enough to cause secondary disruption of vital services, in turn causing disease, death and disability, and which then can self-amplify.
H5N1 in humans is very rare at the time of writing this, with no human to human (H2H) transmission detected for now. Its lethality has been extremely high in the reduced number of human beings that have been known to catch it symptomatically, so it's thought of as one of the concerning candidates. H7N9, less lethal, is another. Either, or another candidate, could acquire H2H capacity and still exhibit a high enough lethality. If and when that happens, the time to strategise at leisure will be gone.
In recent years there have been some human cases from birds, with no apparent H2H. Recent clades in birds seem less lethal for humans, which is not necessarily good news if it flies under the radar. So we could say that's "more of the same": a clock ticking, not noticeably faster, but ticking.
As of Jan 2023, a somewhat new development is being recognised. H5N1 is, as before, in birds in many countries, and maybe in higher numbers though that's hard to ascertain. An extra element is that it's being recognised in mammals, both in farms (minks), and in the wild: bears, some big wild cat.
Some questions are: Is it becoming better adapted at H2H? If it goes H2H, would it be "severe enough"? We need to assume a positive response to these questions, both "just in case" and "because it will happen anyway".
The more urgent question for readers of this page is: What can "we" do for now?
Aerosols[edit | edit source]
We know about aerosol transmission. That it happens, that it's dominant, & what works to lessen it by a lot.
Rapid tests[edit | edit source]
We also know about rapid tests. Not perfect but very useful. There's knowledge to make the best use of it.
Vaccines?[edit | edit source]
We have technology to make vaccines fast. Not egg based. In big quantities. _I think_. I say this because, frankly, I'm not & don't want to be a vaccine expert.
Personal protection[edit | edit source]
The technology to make really good personal protective equipment is there. It's not even all in China, I'd say.
Sociology & governance[edit | edit source]
We know govts & populations are Exactly What They Are. I.e., mostly a mess.
Timing[edit | edit source]
We know Timing Matters. What sticks in day 1 (teachable moment) is hard to undo.
Which is why many still wash their hands obsessively as their only action and why shops & schools keep outdated advice running.
So, we have learned massively. Let's call that Knowledge Resources. I think we can go back to our outline? Ya reckon?
A more complex situation[edit | edit source]
We're in a more complex situation. Climate change is worse. Governance hasn't improved, with bad actors & vulnerable actors not acting well. Social networks have proved vulnerable & their own dynamics are part of the problem. We're still learning.
What has not changed[edit | edit source]
Ok, so what stays firmly in place?
Vital needs[edit | edit source]
Our needs stay. Some have become clearer.
Food, water, shelter, medicines & health care.
Company & education... Yes, we have seen that there's vital needs (try staying alive without O2, or without insulin if you're insulin-dependent) and important needs (education etc).
Important needs[edit | edit source]
So let's make room for non-directly vital needs. Being with age peers. Having connections to ask for help if the parents are behaving in scary ways today. Learning about the world, expanding our horizons, acquiring skills for fun or profit.
Systems to provide for needs[edit | edit source]
Around the needs, we still have the systems we created to provide for those needs. And, if the systems are broken, we still have the pieces. And everything else that's lying around them. Things that could be part of ad hoc systems. In short, we have SCIM. Now...
Aerosol pandemic/Needs_and_Systems
What to do next[edit | edit source]
And keep going. Because we have things we need to develop.
More technology[edit | edit source]
More technology. Better braces Aerosol pandemic/Adjusters (I've touched it recently), more info on UV in Aerosol pandemic/UV and updated links to the cool new stuff about #corsirosenthalbox with quieter fans and :gasp: the CDC maybe buying it? To be added to Aerosol pandemic/Filter.
If a few people become appropedia editors, that would be massive.
Strategy[edit | edit source]
We need to develop the strategic elements.
Simple things like some sort of Known Unknowns maintained by collecting the articles of people who have earned the public trust, giving us the questions, organised around areas like Who catches it, Who transmits it, etc.
c) And more complex issues like How do we do contact tracing, either improving apps or increasing their use or doing it on paper. @yoryobass & @AnnaLlupia have looked at stuff.
d) How do we help each other isolate etc.
e) How do we improve & detail the set of strategies.
So, maybe I can look at the hashtags #fluscim2 & #covidstrategy, and mop up. But just for now, let me say thanks to @Fla_Medic, for keeping us up to date with H5Nx & many other things, & for RT'ing the first post of this thread gave me a boost. And call it a day for now.
PS1: Research. @patientled. From day one.
PS2: Global perspective. From day one. Maybe an opt-in layer for strategy. #covidstrategy.
PS3: We also need a number of people to look at http://resiliencemaps.org/files/fluscim. It's not a big ask, just a few zoom meetings to extract whatever is useful and give it legs. Then drop the banana peels (what's not useful). Who organises?
PS4: http://appropedia.org/Pandemic_OSAT I.e. open tech guided by prioritised needs. With a view to make stuff doable by commercial entities if they can scale, while keeping openness.
Ok, so, #OODA done, including the action of writing the above. What next? Probably write the above in my appropedia user page for now, ask for comments, complete it, add links, turn it into a PDF and place it with the other docs, maybe make a video or three. Translate.